Table 3

Summary of antibiotic durations for common ICU infections

InfectionAntibiotic recommendationsComments
CAUTI*
  • 3–7 days of antibiotic therapy is sufficient for most patients

  • 10–14 days if symptoms do not improve early in the course

  • 3 days is considered in age <65 years, and mild infection with no upper tract symptoms, and catheter has been removed.

  • If treating with levofloxacin, consider 5 days only if patient is not severely ill.

VAP
  • 7 days of antibiotic therapy

  • In ARDS or structural lung disease with virulent or resistant infections, 10–14 days may be considered.

  • In severe immunocompromise such as organ transplant, 10–14 days may be considered.

CRBSI
  • 7 days of antibiotic therapy for GNBs or coagulase-negative staphylococci

  • 14 days if Staphylococcus aureus (and uncomplicated infection) or Candida

  • If endocarditis or other complicated form of CRBSI, 4–6 weeks may be required.

Bacteremia
  • 7 days of antibiotic therapy for GNBs or coagulase-negative staphylococci

  • 14 days if S. aureus (and uncomplicated infection) or Candida

  • It must be kept in mind to rule out an underlying source of the bacteremia.

Intra-abdominal infection†
  • 3–5 days when source control is present

  • 5–7 days and then re-evaluate when source control is not present

Surgical site infection
  • 1–2 days if significant cellulitis or systemic symptoms

  • The tenant of treatment is drainage of the infected material.

Ventriculitis
  • 10–14 days of antibiotic therapy

  • 21 days if S. aureus

Necrotizing skin and soft tissue infection
  • 2–4 days after final surgical debridement provided certain conditions are met (see section in text)

  • *The recommendations and comments are in agreement with the IDSA guidelines.64

  • †The recommendations are in agreement with the SIS guidelines.84

  • CAUTI, catheter-associated urinary tract infection; CRBSI, catheter-related bloodstream infection; GNBs, Gram-negative bacilli; ICU, intensive care unit; SIS, Surgical Infection Society; VAP, ventilator-associated pneumonia.